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To assess the value of placental shear wave velocity (SWV) measurement by acoustic radiation force impulse (ARFI) imaging for the diagnosis of pre-eclampsia and to determine the relationship between the SWV and the severity of pre-eclampsia.A prospective study was performed at a center in Turkey between August 2014 and March 2015. The study included consecutive pregnant women in the second or third trimester diagnosed with pre-eclampsia and healthy pregnant women without pre-eclampsia of similar ages. Patients with pre-eclampsia were divided into two groups (severe or mild disease) on the basis of revised American College of Obstetricians and Gynecologists criteria. All patients underwent ARFI, and the SWV was measured at several placental locations.Overall, 86 women were enrolled (42 with pre-eclampsia, 44 controls). Minimum, maximum, and mean SWV values were significantly higher in the pre-eclampsia group than in the control group (P

Summary Aim Given the lack of studies evaluating pituitary iron overload in patients with thalassemia major, we used magnetic resonance imaging (MRI) to evaluate these patients and the factors affecting the disease process. Materials and methods The 84 patients with β-thalassemia major who were included in this study were referred to our clinic for cardiac and hepatic T2* MRI. T2*-weighted images of the pituitary gland, heart, and liver were obtained using a 1.5-tesla MRI unit and a multi-echo gradient-echo sequence. Associations between pituitary T2*, cardiac T2*, hepatic T2*, pituitary height, serum ferritin (SF) level, patient age, and other demographic findings were assessed. Results Pituitary T2* values correlated with hepatic T2* values, cardiac T2* values, SF level, and patient age (P ≤ 0.001, 0.001, 0.001, 0.01, respectively) but not with pituitary height (P = 0.76). Pituitary and cardiac T2* values were lower in the subset of patients who underwent splenectomy (P = 0.046 and P = 0.002, respectively). Conclusion Pituitary iron overload rapidly increases during puberty and in this study correlated with cardiac and hepatic T2* values, patient age, SF level, and liver size, but not with the height of the pituitary. Pituitary iron overload also increases following splenectomy. Together, these findings indicate that numerous factors contribute to pituitary iron overload.

Background:: Femoroacetabular impingement (FAI) is one cause of hip pain, and is an under-recognized cause of early osteoarthritis, especially in young and active people. The prevalence of FAI in adults is approximately 10 – 15% and depending on the clinical and radiographic findings, two types of impingement (which are often present in combination) can be distinguished: the cam type and the pincer type. Most patients (86%) have a combination of both forms of impingement. Objectives:: The aim of our study was to evaluate the prevalence and gender differences in the radiological parameters associated with cam and pincer FAI morphologies in an asymptomatic young population, using computed tomography (CT). Patients and Methods:: A retrospective study was performed on 200 individuals (400 hip joints), ranging from 15 - 40 years of age, who were seen in our hospital between July of 2013 and April of 2014 for nonspecific abdominal pain. Multiplanar reformatted CT images of these patients were assessed for the existence of radiological abnormalities, and six measurements (acetabular version angle, acetabular index, lateral center-edge angle, alpha angle in the oblique axial plane, alpha angle in the radial [one o’clock position] plane, and femoral head neck offset) were made relating to the FAI. Results:: The data showed that 69.2% of the women’s joints and 60.5% of the men’s joints had at least one abnormal parameter associated with the FAI. Of the joints, 34.25% had two or more abnormal parameters, and in 38 (19%) of the patients, these abnormalities were bilateral. Unlike previous studies, we found that only 15% of the joints had mixed FAI morphologies. Conclusion:: The prevalence of radiological parameters associated with FAI is high, even in an asymptomatic young population. This high frequency of features may suggest that the threshold values have been set too low in the current literature, or that these findings may reflect anatomical variation rather than true pathological abnormalities.

Our aim in this study was to analyze the findings of brain magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) of children with vitamin B12 deficiency. This study included 14 cases. The findings of brain MRI and MRS in all cases were investigated. Four patients had been followed up and mean follow-up time 71.8 (59–85) day. Eight patients of the cases (57 %) had at least one abnormal MRI finding. The most commonly found MRI findings were thinning of the corpus callosum and brain atrophy, respectively. The mean ratio of NAA/Cr and Cho/Cr were measured in MRS, with values of 1.31 ± 0.17 and 1.04 ± 0.27, respectively. In two of three patients with abnormal MRI studies at presentation, subsequent MRI showed improvement while one patient remained unchanged. An increase in the ratios of metabolites were found in one case with control MRS. There was no lactate peak. Brain MRI was abnormal in more than half of the cases of children with vitamin B12 deficiency. Our radiologic findings similar with literature. There was no identifiable lactate peak. B12 deficiency could be the cause of the thinning of the corpus callosum and brain atrophy in the children that were given a brain MRI.

Background To compare retrobulbar blood flow in patients with central serous chorioretinopathy (CSC) and healthy subjects using color Doppler ultrasonography. Methods Thirty patients (age 23–54 years) with a first episode of acute CSC and 30 healthy controls (age 30–44 years) were evaluated. The peak systolic blood flow velocity, end-diastolic velocity (EDV), resistance index (RI), and pulsatility index (PI) were measured in the ophthalmic, posterior ciliary, and central retinal arteries. Results The posterior ciliary and central retinal artery EDV were lower in the patient group than in the control group, whereas RI and PI values were significantly higher (p

To evaluate the relationship between varicocele and ankylosing spondylitis (AS) via color duplex sonography (CDS).Thirty male patients (age range 18-40 years, mean age 30.27 years) with AS and 30 male healthy controls (age range 20-36 years, mean age 27.23 years) were evaluated for varicocele using CDS.Vein diameter in right and left pampiniform plexus (PP) in the AS group was significantly higher than in the control group (p0.001 and p = 0.003, respectively). The incidence of varicocele was observed as 33.3 % in the AS group and 10 % in the control group. However, the difference was statistically significant (p = 0.028). The rate of right, left, and bilateral varicocele was 3.3 % (1 patient), 23.3 % (7 patients), and 6.6 % (2 patients), respectively, in the AS group, versus 0, 10, and 0 % in the control group (p = 1.000, p = 0.166, and p = 0.492, respectively).The incidence of varicocele in AS patients is higher than in control subjects, and the difference is statistically significant. Therefore, varicocele must be taken into consideration and investigated in patients with AS.

Epilepsy is a common chronic disease characterized by spontaneous and recurrent seizures. Along with the increases in life expectancy, the prevalence of epilepsy in adults increased in parallel. 3.0-T MRI provides high signal/noise ratio and is an important tool in the determination of epileptic lesion in epilepsy patients. Our aim in this study was to research and compare 3.0-T MRI findings of Turkish epileptic patients that are resistant and non-resistant to medical treatment. 3.0-T MRI images from 264 consecutive patients, of which 150 were males and 114 were females (age range 18–82 years; mean age 31.3 years) were examined, retrospectively. Among those patients, 94 were resistant to medical treatment (DRE+) and 170 were non-resistant (DRE−). Epileptic lesion was determined in 119 of the patients. Epileptic lesion was determined in sixty-three patients who were resistant to medical treatment and in fifty-six patients who were non-resistant. Epileptic lesion was determined in approximately half of the adult epilepsy patients by using 3.0-T MRI. This study demonstrates a high prevalence of brain abnormalities in Turkish epileptic patients with DRE+. The lesion was determined in 67% of patients with medical treatment resistance, while the percentage for the other group was only 32.9%. The ratio of epileptic lesion determination by using 3.0-T MRI was quite higher in the medical treatment resistant group than the non-resistant group.

Computed tomography (CT) is the gold standard for assessing interstitial lung disease (ILD) in patients with systemic sclerosis (SSc). In this study, we performed a quantitative calculation of ILD severity by examining the lung volume of SSc patients.The present study was performed retrospectively on 38 patients with SSc who were referred to our clinic. Patients were divided into two groups based on high-resolution computed tomography (HRCT): patients with ILD and patients without ILD.The percentage of lower lobe volume (PLLV) was calculated using HRCT. In addition, we evaluated the PLLV in all patients according to age, diffusing capacity of the lung for carbon monoxide (DLCO) and spirometric findings, and assessed the relationships among these factors.PLLV of the right lung in patients with ILD was reduced when compared with patients without ILD (P=0.041). The PLLV of the right lung in patients with ILD was negatively correlated with age and forced vital capacity (FVC; P=0.01 and P=0.012, respectively).The PLLV of the right lung may decrease in SSc patients with ILD. In these patients, the PLLV may be a quantitative parameter indicating damage in the lung.

The aim of this study is to investigate the frequency of the SHC variations, and the distribution of the SP lengths in different age and sex groups using MDCT. MDCT scans were performed in 805 patients (401 males, 404 females). The patients were divided into six groups according to their ages. The length of the styloid process (SP) and its angulation on the transverse (TA) and sagittal (SA) planes were measured. Structural variations of the SHC were observed by means of three-dimensional (3D) and multiplanar reconstruction (MPR) images. Absence of the styloid process (n = 10), double proximal origin (n = 13), segmentation (n = 223), complete ossification (n = 24), and an SP with three proximal parts in one patient were among the anomalies detected. The mean length of the SP was greater in males than in females (33.2 ± 13.2 vs. 29.6 ± 10.5 mm, P < 0.001). Elongated SP (ESP) was observed in 56 % of the patients in the study group, and this ratio was the highest in Group 3 with 65.4 % (P < 0.05). TA and SA were 70.2° ± 4.1°, 69.9° ± 4.2° and 86.6° ± 6.5°, 88.3° ± 6.6° for the right and left sides, respectively. Besides, 3D and MPR images also present detailed and reliable data to radiologists and surgeons for the evaluation of the SHC. ESP has been detected in more than half of the patients, being more frequent in males and in individuals in the fifth decade of life. For an accurate diagnosis, clinicians should consider the ESP while evaluating the patients in this age group.

Objectives: The aim of this study was to determine the frequency and clinical importance of anatomic variations of the colon. Materials and methods: Multi-detector computed tomography (MDCT) of the abdomen for various indications was performed in 1300 patients in radiology department between January 2010 and September 2011 were retrospectively analyzed to investigate the anatomic variations of colon. Results: The total number of patients undergoing MDCT scans was 1300, of which 640 were female and 660 male. The mean age of patients was 43.02 years (2-92). The number (%) of colons according to their position were as: 34 (% 2,6) anterior and 14 (% 0,9) posterior hepatodiafragmatic, 40 (% 3) interposition of colon between psoas and right kidney, 3 (% 0,2) interposition of colon between psoas and left kidney, 4 (% 0,3) right retrorenal, 16 (% 1,2) left retrorenal, 2 (%0,2) bilateral, 10 (% 0,8) pancreaticogastric, 5 (% 0,4) retrosplenic and 64 (% 4,9) high caecum. Conclusion: Knowledge of the anatomic variations of colon is important for surgical planning or interventional radiologic procedures. Multi-detector computed tomography allows detailed visualization of these variations., Giriş: Bu çalışmanın amacı kolonun anatomik varyasyonlarının sıklığını ve klinik önemini belirlemektir. Gereç ve yöntem: Ocak 2010-Eylül 2011 tarihleri arasında, radyoloji bölümünde, farklı nedenlerden dolayı abdomen çok kesitli bilgisayarlı tomografi (ÇKBT) çekilmiş, 1300 hasta retrospektif olarak, kolonun anatomik varyasyonları açısından incelendi. Bulgular: ÇKBT çekilmiş 1300 hastanın, 640\'ı kadın ve 660\'ı erkek idi. Ortalama yaş 43,02 yıl (2-92) idi. Kolon varyasyonlarının sayısı: 34 (% 2,6) anterior, 14 (% 0,9) posterior hepatodiyaframatik, 40 (% 3) sağ böbrek-psoas interpozisyonu, 3 (% 0,2) sol böbrek-psoas interpozisyonu, 4 (% 0,3) sağ retrorenal, 16 (% 1,2) sol retrorenal, 2 (%0,2) bilateral, 10 (% 0,8) pankreatikogastrik, 5 (% 0,4) retosplenik kolon ve 64 (% 4,9) yüksek yerleşimli çekum. Sonuç: Kolonun anatomik varyasyonlarının bilinmesi cerrahi ve girişimsel radyolojik işlemlerde önemlidir. ÇKBT bu varyasyonların ayrıntılı bir şekilde gösterilmesine olanak sağlamaktadır.

This study aims to collect data by multidetector computed tomography (MDCT) on the diameter of the normal common bile duct (CBD) and the diameter of CBD after cholecystectomy. In this retrospective study, CBD measurements were performed on axial oblique images, perpendicular to the long axis of the distal CBD. The mean diameter of the normal CBD was measured in 604 patients without cholecystectomy. The patients were divided into 6 groups according to their age. Analysis of variance (ANOVA) was used to compare data obtained from the six age groups. The mean diameter of the CBD of 46 patients who had cholecystectomy was calculated. The results were compared with age matched control group by Student's t test. The largest diameter of CBD ranged from 1.8 to 11.8mm. The mean of the largest diameter of 604 subjects was 4.77 ± 1.81. The diameter of the CBD significantly increased with age. Mean largest CBD diameters of postcholecystectomy subjects (7.28 ± 2.37) were significantly greater than age matched control group. In conclusion the diameter of CBD shows a considerable increase with age. The largest diameter of the CBD is up to 6mm in most of the subjects. An upper limit of 8mm appears reasonable after the age of 50; and an upper limit of 10mm seems appropriate for cholescystectomized subjects.

Pulmonary Veins are one of the major structures of circulation. In the last decade, pulmonary veins have been known to play an important role as the triggering focus of the electrical activity in atrial fibrillation. Primary treatment method of AF is RF ablation of the focus. For the best ablation, the anatomy of PVs should be well established before the procedure. MATERIAL AND METHODS: In our radiology department, 783 patients underwent computed tomography angiography between January 2008 and May 2010. Patients were referred for coronary CTA because of known or suspected coronary artery disease or computed tomography pulmonary angiography (CTPA) because of known or suspect pulmonary embolism. All scanning was performed on Philips Brilliance 64 slice Multidetector CT. The group consisted of 402 male and 381 female patients with the average age of 48 (range 14–89). CT data of patients were retrospectively reviewed to identify the PV anatomy and to determine anatomic variants and anomalies. RESULTS: In the majority of cases, two pulmonary veins drain into the left atrium on each side. Eighteen and eight variations were found in the right and left sides, respectively. Most frequent combined variations were 2R-4L (32.3%) and 4L was the more frequent single variation type (76%). In addition to that one Situs inversus totalis (0.12%), two partial anomalous pulmonary venous returns (0.25%) and one scimitar syndrome (0.12%) were found. CONCLUSION: This study showed that multiple types of variations of PVs can be found with increasing patient number. Therefore, for the successful ablation and surgery without any complications, the anatomy of PVs should be known before the procedure. MDCT is a reliable imaging method for the detailed cross-sectional and 3D anatomy.

The aim of this study is to depict anatomic characteristics of sinuatrial nodal artery (SANA) and atrioventricular nodal artery (AVNA) of the heart with multidetector computed tomography. In our study, 400 patients referred to radiology departments of two institutions for coronary CT angiography were retrospectively evaluated. 350 patients had been examined by dual-source 64-slice CT, and 50 patients by 64-section multidetector CT. Transverse sections with a thickness of 0.6 mm were used in dual-source 64-slice CT studies, and 0.8 mm were used in 64-section multidetector CT examinations for the evaluation of coronary arteries and conduction system branches. Anatomic origin, localization of the origin, diameter, number, course, and variants of the SANA and AVNA were examined with coronary multidetector CT angiography. SANA and AVNA could be imaged by multidetector CT in all patients. There was a single SANA in 383 (95.7%) patients, and two SANAs in 17 (4.2%) patients. Two hundred thirty-three (58.2%) patients had one SANA originating from right coronary artery (RCA), 149 (37.2%) patients had one SANA originating from left circumflex (LCX) artery, and one patient had a SANA originating from the aorta. AVNA originated from distal RCA in 351 patients (87.7% of all patients), and from distal LCX artery in 49 patients (12.3% of all patients). The arteries that supply the sinuatrial node and atrioventricular node can be imaged with multidetector CT. These arteries have variations in number, origin and course.

A 25-year-old woman who had undergone the Blalock-Taussig shunt operation for double-outlet right ventricle (DORV) in her childhood was admitted to our hospital with mild cyanosis and dyspnea on exertion. To evaluate the precise complex anatomy of this abnormality, we carried out multidetector computed tomography (MDCT) angiography. MDCT clearly revealed both an occluded Blalock-Taussig shunt and a complex cardiac anatomy, including DORV, a doubly committed ventriculoseptal defect, pulmonary stenosis, persistent left superior vena cava, minor aortic arch anomalies, and total anomalous hepatic venous drainage. To our knowledge, our report is the first description of such a complex cardiac anatomy to be revealed with MDCT.

Objective: In medicine, traction is used for act of pulling force for producing distraction or separation between two or more parts of body. However, it is limited to the cervical or lumbar spine in physiotherapic application. We aimed to investigate effect of new traction technique on anatomic structures of lumbar vertebrae, and its’ relation to different application of heating

OBJECTIVE. The classical findings in hydatid disease caused by Echinococcus granulosus with liver or lung involvement are well known. However, diagnosing hydatid disease at unusual locations may be challenging because of variable imaging appearances depending on the host reaction. The purpose of this pictorial essay is to review the sonographic, CT, and MRI features of extrahepatic abdominal hydatid disease including intraperitoneum, retroperitoneum, diaphragma, bone, and soft tissue of the abdomen.CONCLUSION. Extrahepatic abdominal hydatid lesions have nearly identical imaging features, including the presence of cyst wall calcification, daughter cysts, and membrane detachment. The combinations of radiologic and serologic tests especially in patients living in the endemic areas contribute to the diagnosis. Despite their rarity, being familiar with the spectrum of radiologic findings in these unusual sites is helpful to improve diagnostic accuracy.

Background: Diffusion-weighted magnetic resonance imaging (DWI) is a widely-accepted diagnostic modality whose efficacy has been investigated by numerous past studies in the differentiation of malignant lesions from benign entities. Aims: The aim of this study was to evaluate the efficiency of diffusion-weighted magnetic resonance imaging in the characterization of renal lesions. Study Design: Diagnostic accuracy study. Methods: A total of 137 patients with renal lesions were included in this study. The median apparent diffusion coefficient (ADC) values as well as the b 800 and b 1600 signal intensities of normal kidneys, solid components of mixed renal masses, and total cystic lesions were evaluated. Results: There were significant differences between the ADC values of lesions and normal renal parenchyma, and between the ADC values of benign and malignant renal lesions on DWIs at b values of 800 and 1600 s/mm² (p

Atypical coarctation of the descending thoracic and abdominal aorta is a very uncommon vascular disease. Congenital, acquired, inflammatory, and infectious etiologies have been proposed. Patients typically presents with uncontrolled secondary hypertension in the upper half of the body or hypotension in the lower extremities in the first three decades of their lives. We report the case of a 20-year-old man with severe hypertension. Diffuse coarctation of thoracoabdominal aorta associated with bilateral renal artery stenosis was demonstrated clearly by multidetector CT angiography. This is the first case of atypical aortic coarctation diagnosed by MDCTA.

Purpose Our aim was to evaluate with sonography the volume changes of the gallbladder after intravenous administration of nonionic, iodinated contrast agents with or without ingestion of contrast agent or water. Methods A total of 191 patients received intravenous injection of 50 ml of nonionic contrast agent (Group A), intravenous injection of 100 ml of contrast medium (Group B), intravenous injection of 100 ml of contrast medium together with ingestion of 1000 ml of a dilute solution of contrast medium (Group C), or 1000 ml of water taken orally (Group D). The gallbladder volume was measured by ultrasonography in the fasting state in all groups, 15 minutes after intravenous injection of contrast medium in Groups A, B, and C and 30 minutes after water ingestion in Group D. Results In all groups, the volume of the gallbladder was statistically lower after the procedure than before. There was no significant difference among the groups in terms of this gallbladder volume change. Conclusions Intravenous injection of nonionic, iodinated contrast medium or ingestion of water or a dilute solution of contrast medium for various radiological examinations results in contraction of the gallbladder. Contrast-enhanced radiological examinations may interfere with sonographic evaluation of the gallbladder. If necessary, gallbladder ultrasonographic examination should be repeated with the patient in a fasting state. © 2005 Wiley Periodicals, Inc. J Clin Ultrasound33:214–217, 2005

Background. Fascioliasis is a disease caused by the trematode Fasciola hepatica. Cholangitis is a common clinical manifestation. Although fascioliasis may show various radiological and clinical features, cases without biliary dilatation are rare. Case report. We present unique ultrasound (US) and magnetic resonance cholangiopancreatography (MRCP) findings of a biliary fascioliasis case which doesn’t have biliary obstruction or cholestasis. Radiologically, curvilinear parasites compatible with juvenile and mature Fasciola hepatica within the gallbladder and common bile duct were found. The parasites appear as bright echogenic structures with no acoustic shadow on US and hypo-intense curvilinear lesions on T2 weighted MRCP images. Conclusions. Imaging studies may significantly contribute to the diagnosis of patients with subtle clinical and laboratory findings, particularly in endemic regions.

We report the case of a 40-year-old woman, who had extensive hepatic necrosis, multiple liver infarctions, subcapsular liver hematoma, acute renal failure, and massive ascites in the setting of hemolysis, elevated liver enzyme levels, and a low platelet count (HELLP) syndrome in the post-partum period. Our purpose was to describe the effects of serious obstetric complications on maternal and perinatal outcome in pregnancies complicated by HELLP syndrome and the role of radiological findings in the diagnosis and course of the patient. We describe a patient who had abnormal sonographic findings of the liver immediately post-partum before signs and symptoms of severe preeclampsia and HELLP syndrome. The abnormal sonographic appearance of the liver prompted further investigation and was instrumental in the management of this case. These serious hepatic complications can be initially detected by ultrasonography. In addition, computed tomography of the abdomen confirmes the diagnosis and delineates the lesions more precisely. Moreover, ultrasonography can be used as a screening imaging modality compare to computed tomography and magnetic resonance imaging.

This prospective study was performed to determine whether extracorporeal shock-wave lithotripsy (ESWL), widely used for treating renal and ureteral stones, affects the kidney interlobar artery resistive index (RI).A total of 43 patients (30 with renal and 13 with ureteral stones) underwent color Doppler examination before and 30 min and 3 h after ESWL. Seventeen patients with renal and nine with ureteral stones underwent Doppler examination 2 weeks later. Measurements were made near the stones (nearby region), at least 2 cm from the stones (remote region) and in the contralateral kidney for renal stones, and in the ipsilateral and contralateral kidneys for ureteral stones.In patients with renal stones, the RI was increased 30 min and 3 h after ESWL in the nearby and remote regions, and more markedly in the former. In the contralateral kidney, there was an increase in RI only at 3 h, which was less than that in the ipsilateral kidney. The RI at 2 weeks post-ESWL in the nearby region and contralateral kidney did not differ from the pre-ESWL values. ESWL performed for ureteral stones caused no increase in RI in the ipsilateral kidney.Patients with renal stones had a temporary increase in RI in the hours following ESWL in both the ipsilateral and contralateral kidneys, which was highest in the region near the stones and lowest in the contralateral kidney. Two weeks later, the RI in both areas had returned to pre-ESWL levels.

Summary Aim To evaluate the blood flow in arteries of the orbit in patients with psoriasis. Methods In total, 30 patients with psoriasis and 30 healthy control subjects were recruited to the study. Standard ophthalmic evaluation, fundus examination and retrobulbar colour Doppler ultrasonography assessment were performed. The ophthalmic, posterior ciliary and central arteries were evaluated, and peak systolic blood flow velocity, end diastolic velocity, resistance index and pulsatility index were measured. Results of the measurements were compared between the two study groups. Results There were significant differences in blood flow parameters of the orbital arteries between the psoriasis group and the control group. Conclusions The haemodynamics of the orbit might be affected in patients with psoriasis.

Objectives To compare the diagnostic success rate of acoustic radiation force impulse (ARFI) elastography with those of sonography and computed tomography (CT) for acute pancreatitis at hospital admission. Methods B-mode sonography and ARFI elastography were performed on 88 patients with symptoms of acute pancreatitis and 50 healthy control participants who were admitted to our hospital between February 2013 and July 2013. Acute pancreatitis was verified in the 88 patients based on clinical and laboratory findings. Computed tomography was performed on 41 patients, and the CT results from these patients were compared with those of ARFI elastography. The appearances of the pancreases of the patients were classified into 6 groups using visual color encodings obtained with ARFI elastography. The elasticity values of pancreatic head, body, and tail regions were evaluated with Virtual Touch imaging and Virtual Touch tissue quantification (Siemens Medical Solutions, Mountain View, CA). The success rates of sonography, CT, and ARFI elastography for diagnosing acute pancreatitis at hospital admission were compared. Results Forty-six of the 88 patients had a diagnosis of pancreatitis by B-mode sonography; pancreatitis was diagnosed in all patients by ARFI elastography; and 10 of 41 patients could not be diagnosed by CT. The sensitivity and specificity of Virtual Touch tissue quantification were 100% and 98%, respectively, when a cutoff value of 1.63 m/s was used. The control group had color scores of 1 or 2, whereas all patients with pancreatitis had color scores of 3 to 6 on color scale evaluation with Virtual Touch imaging. Conclusions Acoustic radiation force impulse elastography is a rapid, radiation-free, and noninvasive tool for diagnosis of acute pancreatitis at initial hospital admission, with a higher success rate for diagnosis of acute pancreatitis than the grayscale sonography and CT.

Background The objective of this study was to retrospectively investigate and compare multidetector computed tomography findings of hepatocellular carcinoma (HCC) in hepatitis B virus (HBV)-positive and -negative patients. Methods Triphasic (arterial, portal venous, and delayed phases) dynamic multidetector computed tomography (CT) was performed in 83 patients with HCC, 48 of whom were HBV-positive. The diagnosis of HCC was established with typical CT imaging findings (68 patients) or histopathological evaluation (15 patients). Distribution of solitary, multiple, and diffuse HCC, portal/hepatic vein thrombosis, metastasis, and patients with high alpha-fetoprotein levels in the HBV-positive and -negative groups were compared using the Kolmogorov–Smirnov test. Lesion size, alpha-fetoprotein levels, arterial, portal, delayed enhancement, and washout of lesions were compared using the Student’s t-test. Results Hypervascular tumors were observed in 72 (87%) patients, and hypovascular tumors were found in 11 (13%) patients. The mean alpha-fetoprotein value of HBV-positive patients with HCC was significantly higher than the mean alpha-fetoprotein value of HBV-negative patients (P 0.05). The mean diameters, arterial, portal, and delayed phase attenuations, and washout of HCC were not significantly different (P > 0.05). Conclusions Multidetector CT imaging findings of HCC in HBV-positive and -negative patients are alike. Portal/hepatic vein thrombosis and metastasis are more frequently observed in HBV-positive patients. Alpha-fetoprotein levels are higher in HBV-positive patients.

Objectives: Presently, hysterosalpingography (HSG) is used as a means to evaluate women with infertility and repetitive pregnancy loss. Venous intravasation is a complication and potential pitfall during HSG and analogous procedures including hysteroscopy. The aim of our study was to assess the venous intravasation and to obtain critical information for more secure and more accurate procedures. In particular, the primary goal of the present study was to compare HSG without and with intravasation to identify differences seen on HSG and to assess the predisposing factors of intravasation. The secondary goal was to describe clinical- and imaging-based novel classification of intravasation. Materials and Methods: This study included a patient cohort of 569 patients who underwent HSG between 2008 and 2011 at our center in the absence (control group) or presence (study group) of intravasation. Intravasation classified from level 0 (no intravasation) to level 3 (severe intravasation) was compared with preprocedural (demographic and clinical) and procedural (HSG) data. Data were analyzed using Statistical Package for Social Sciences (SPSS) statistical software. Results: Of the 569 patients undergoing HSG, 528 showed no intravasation and 41 (7.2%) patients showed intravasation when associated with preprocedural (leukocytes, menometrorrhagia, secondary infertility, ectopic pregnancy, abortus, polycystic ovaries, endometriosis, and interventions) and procedural (pain, scheduling, endometrial-uterine nature, and spillage) parameters. Moreover, intravasation was lower in women with smooth endometrium, triangular uterus, and homogeneous peritoneal spillage. No association was found between age, tubal patency, increased pressure, and intravasation. Conclusions: Using a novel classification method, intravasation can be observed in women during HSG and associates with preprocedural and procedural predisposing factors in subsumed conditions. This classification method will be useful for improving the efficiency and accuracy of HSG and related procedures by minimization of severe complications caused by intravasation.

The urachus is a midline tubular structure that extends upward from the dome of the bladder toward the umbilicus. This tubular structure normally involutes before birth, remaining as a fibrous band with no known function. Persistence of all or any portion of the fetal urachus results in several anomalies, the most common of which is the urachal cyst (Yu JS, Kim KW, Lee HJ, Lee YJ, Yoon CS, Kim MJ, Radiographics, 21:451-4611, 2001; Ohgaki M, Higuchi A, Chou H, Takashina K, Kawakami S, Fujita Y, Hagiwara A, Yamagishi H, Surg Today, 33:75-77, 2003). Although most urachal cysts are asymptomatic, there are a few reports about intraperitoneal rupture of infected urachal cysts, all of which caused peritonitis and sepsis (Ohgaki M, Higuchi A, Chou H, Takashina K, Kawakami S, Fujita Y, Hagiwara A, Yamagishi H, Surg Today, 33:75-77, 2003; Kojima Y, Miyake O, Taniwaki H, Morimoto A, Takahashi S, Fujiwara I, Int J Urol, 10:174-176, 2003; Agatstein EH, Stabile BE, Arch Surg, 119:1269-1273, 1984). We report the imaging and operative findings of a patient, presented with a urachal abscess after a spontaneously ruptured urachal cyst.

Objective To determine the relationships between serum leptin and levels of lipoprotein(a) [Lp(a)], apolipoprotein A-1 (ApoA-1) and apolipoprotein B (ApoB) in patients with cholelithiasis. Methods Patients with ultrasound-confirmed cholelithiasis and controls frequency-matched for age, sex, body mass index, fasting blood glucose and haemoglobin A1c levels were recruited. Fasting blood samples from all study participants were assayed for glucose, haemoglobin A1c, total cholesterol, high density lipoprotein-cholesterol (HDL-C) and triglyceride. Serum Lp(a), ApoA-1 and ApoB levels were measured using nephelometric assays; serum leptin was measured using an enzyme-linked immunosorbent assay. Results A total of 90 patients with cholelithiasis and 50 controls were included in the study. Serum levels of leptin, Lp(a), total cholesterol, triglyceride and ApoB were significantly increased, and levels of ApoA-1 and HDL-C were significantly decreased, in patients with cholelithiasis compared with controls. Serum leptin in patients with cholelithiasis were significantly positively correlated with Lp(a) and ApoB and negatively correlated with ApoA-1. Conclusions Patients with cholelithiasis have higher leptin levels and an altered lipoprotein profile compared with controls, with increased leptin levels being associated with increased Lp(a) and ApoB levels, and decreased ApoA-1 levels, in those with cholelithiasis.

Background A risk factor assessment that reliably predicts whether patients are predisposed to intracranial aneurysm (IA) rupture has yet to be formulated. As such, the clinical management of unruptured IA remains unclear. Our aim was to determine whether impaired arterial distensibility and hypertrophic remodeling might be indicators of risk for IA rupture. Material/Methods The study population (n=49) was selected from consecutive admissions for either unruptured IA (n=23) or ruptured IA (n=26) from January to December 2010. Hemodynamic measures were taken from every patient, including systolic and diastolic blood pressure using a sphygmomanometer. Unruptured IA and ruptured IA characteristics, including aneurysmal shape, size, angle, aspect ratio, and bottleneck factor, were measured and calculated from transverse brain CT angiography images. With ultrasound, the right common carotid artery intima-media thickness was measured, as well as the lumen diameter during systole and diastole. Arterial wall strain, distensibility, stiffness index, and elastic modulus were calculated and compared between patients with unruptured IAs and ruptured IAs. A p-value less than 0.05 was considered statistically significant. Results General demographic data did not differ between patients with unruptured IAs and ruptured IAs. Greater mean intima-media thickness (p=0.013), mean stiffness index (p=0.044), and mean elastic modulus (p=0.026) were observed for patients with ruptured IAs. Moreover, mean strain (p=0.013) and mean distensibility (p=0.024) were decreased in patients with ruptured IAs. Conclusions Patients with ruptured IAs demonstrated decreased arterial distensibility and increased intima-media thickness at the level of the carotid arteries. By measuring these parameters via ultrasound, it may be possible to predict whether patients with existing IAs might rupture and hemorrhage into the subarachnoid space.

To compare retrobulbar blood flow in patients with central serous chorioretinopathy (CSC) and healthy subjects using color Doppler ultrasonography.Thirty patients (age 23-54 years) with a first episode of acute CSC and 30 healthy controls (age 30-44 years) were evaluated. The peak systolic blood flow velocity, end-diastolic velocity (EDV), resistance index (RI), and pulsatility index (PI) were measured in the ophthalmic, posterior ciliary, and central retinal arteries.The posterior ciliary and central retinal artery EDV were lower in the patient group than in the control group, whereas RI and PI values were significantly higher (p .05). The ophthalmic artery peak systolic blood flow velocity and EDV were lower in the CSC than in the control group (p .05) without significant difference in RI and PI.Color Doppler ultrasonography provides additional insights into the pathophysiology of CSC and may support the vasospasm hypothesis.

The aim of this study was to assess the cerebral variations and observe their frequency in the patients who have undergone angiographies with the state of the art 64-slice multidetector computed tomography (MDCT) angiography technique due to various reasons. 500 patients (253 women, 247 men) who had CT scan in the period of April 2008 to March 2010 at Dicle University Medicine Faculty Hospital Radiology Unit were surveyed in this study. Patients who had CT scan with brain CT angio protocol were evaluated using multiplanar, maximum intensity projection (MIP) and volume rendering (VR) images in work station. 773 variations were totally detected among 500 patients. Variations were categorized as Willis polygon, fenestration and other variations. Frequent variations were detected at Willis polygon and posterior communicating artery (PCOA) hypoplasia was detected as the prevalent variation. In the present study, we have demonstrated that cerebral vascular variations are frequent and that these variations can be detected in a non-invasive manner using the MDCT angiography. The results obtained from our study may serve as preoperative guidelines for the units performing surgical procedures.

The gallbladder and the biliary tract are structures in close connection with the adjacent organs and may show a number of variations and anomalies. It is therefore important for surgical purposes to know their anatomy and variations in detail. Various methods are used in the imaging of the variations of the biliary tract and its pathologies, including ultrasonography, computed tomography; direct cholangiographic methods like endoscopic retrograde cholangiopancreatography, percutaneous transhepatic cholangiography, intravenous cholangiography and T-tube cholangiography, as well as indirect methods like magnetic resonance cholangiopancreatography (MRCP) or cholescintigraphy. The aim of this study is to investigate the frequency of the anatomic variations of the biliary tract using 3-T MRCP and to compare the findings with the data in the literature. For the purposes of this study, patients who underwent MRCP at our hospital (Dicle University Hospital) between November 2009 and February 2012 were investigated retrospectively. A total of 590 patients (between 6 and 88 years of age; mean age: 51 ± 9 years) were included in the study. The MRCP imaging was carried out with an magnetic resonance imaging (MRI) device supplied with 3-T magnetic power and by obtaining T2-weighted images through the single-shot fast spin echo technique using the standard body coil. The axial and coronal source images and the reformatted images were evaluated together in terms of the possible anatomic variations. Among the 590 patients included in the study, of 233 (39.5 %) showed anatomic variations at different levels in the intra- and extrahepatic biliary tracts. Among these variations, a right posterior hepatic duct insertion to the left hepatic duct at the level of the bifurcation has been observed in 71 patients (12.1 %), trifurcation was observed in 30 patients (5.1 %) and insertion into the main hepatic duct at the proximal aspect of the cystic duct was observed in 18 patients (3.1 %). At the level of the cystic duct, medial insertion of the cystic duct was viewed in 58 patients (9.8 %), distal medial insertion was seen in 40 patients (6.8 %), a short cystic duct was detected in 10 patients (1.7 %), pancreatobiliary junction anomaly was viewed in two patients (0.4 %) and duplicate anatomic variations have been observed in 42 patients (7.2 %). MRCP studies conducted using 3-T MRI devices may reveal similar or greater numbers of variations when compared to the existing MRCP studies in the literature. 3-T MRI shows a couple of variations. Pointing out these anatomical variations before the surgical intervention may prevent possible iatrogenic traumas. Donors with unsuitable variations for liver transplant may be spotted out at an early phase through the MRCP and certain operations with a high morbidity rate may thus be avoided.

Summary Background: This article is concerned with the evaluation of an adolescent breast mass using imaging methods. Case Report: A 14-year-old girl presented with progressive asymmetric enlargement of the left breast. She had felt a breast lump about 4 months earlier, and over the last 2 months it had been growing progressively. Tumor markers, including AFP, CEA, CA15-3, and CA125, were all normal. Ultrasonography showed a hypoechoichyperechoic, solid mass. Magnetic resonance imaging of the breast revealed a well marginated mass with hypointensity on T1-weighted images and mild hyperintensity on T2-weighted images, which showed mild contrast uptake. Biopsy revealed an undifferentiated malignant mesenchymal sarcoma. The patient underwent mastectomy with axillary lymph node sampling. After the operation, she received 3 cycles of chemotherapy and radiotherapy. Conclusion: Due to the rarity of breast sarcoma and inadequate imaging methods to establish an exact diagnosis, radiologists and clinicians may misdiagnose and merely follow these tumors. As in our case, the histology of the patient may be the leading factor in the management of these tumors. Even in very young patients, progressively growing breast masses should alert the clinician to check for malignancy verified by biopsy.

The goal of our study was to measure the prevalence of anomalies in the extracranial segment of internal carotid artery (ICA), to measure the carotid-pharyngeal distance (CPD).Computed tomography (CT) angiography images of 607 patients were retrospectively examined. The course anomaly and CPD were obtained at different image plane. The patients were divided into four groups according to their age.The incidence of course anomaly in ICA was shown to be 60.3 %. Prevalence of course anomaly showed an increase with age (p0.001). Women had more ICAs with a course anomaly than men (p0.001). Mean CPD among all ICAs was found to be 11.13 mm. When CPD values were compared between the groups, group 1 and group 2 did not have a significant difference, however, there was a significant difference between other groups (p0.05). The CPD significantly decreased with age (p0.001). In ICAs that showed a straight course, the mean CPD was 13.0 mm, while in ICAs that showed course anomaly, the mean CPD was determined to be 9.49, showing a significant difference (p0.05).In conclusion, the number of ICAs that show a course anomaly increases with age, while the CPD decreases. The CPD is decreased in groups that show anomalies. The detection of a decreased CPD before surgery may lower the chance of a perioperative hemorrhage due to artery damage during pharyngeal procedures. Hence, while reporting neck CT angiographies, it may be valuable to also report the presence of ICA anomalies and CPD.

Objectives The present study aimed to present the clinical and multidetector computed tomography (MDCT) findings of patients who were diagnosed with the median arcuate ligament (MAL) syndrome on MDCT retrospectively. Methods Seven hundred forty-four patients in whom MDCT angiography was performed were retrospectively analyzed for investigating incidental MAL syndrome. Results Twenty-one patients were shown to have MAL syndrome. Of 21 patients, 18 with MAL syndrome were asymptomatic. Three patients had some symptoms. On MDCT angiography, proximal narrowing of the arteries was observed in 21 patients. Conclusions MDCT is a minimally invasive and useful tool for the diagnosis of MAL syndrome.

WOS: 000303661600009, PubMed ID: 22253006, A 20 year-old man presented with pain and swelling of the left submandibular area. Neck sonography revealed enlargement of the submandibular gland, coarsening of its echotexture with a few calculi and a multiloculated cystic lesion. Doppler sonography revealed venous flow within the cystic lesion and aneurysmal dilatation of the adjacent facial vein. CT angiography confirmed the facial vein aneurysm. We hypothesize that inflammation of the gland had weakened the wall of the adjacent facial vein, causing aneurysmal dilatation. (C) 2012 Wiley Periodicals, Inc. J Clin Ultrasound, 2012

UNLABELLED: QUESATIONS UNDER STUDY / PRINCIPLES: This study was designed to compare CT and MR appearances of chronic subdural haematomas as well as CT- and MR-guided measurements of haematoma thicknesses. METHODS: CT and MR images of 48 chronic subdural haematomas of 34 patients were reviewed retrospectively. The thickness measurements and imaging characteristics of haematomas were compared. RESULTS: Levelling was observed in 25% of haematomas, and most of them (60%) had intrahaematomal membranes. All membranes could be delineated by MR imaging, whereas only 27% were defined by CT. Mixed density (52%) and T1 hyperintensity (59%) were commonly observed in membraned haematomas, but the difference was not statistically significant. Haematomas were measured significantly thicker on MR images. All patients had been treated with burr-hole cranio-tomy and irrigation. CONCLUSIONS: MR imaging is more sensitive than CT in determining the size and internal structures of chronic subdural haematomas.

Cervical spondylosis is a common disease that results from degenerative changes of the cervical spine and vertigo may occur in this process. The aim of the present study was to assess the blood flow measurements of the vertebral artery (VA) using color Doppler ultrasonography (CDUS) in patients who have cervical spondylosis with and without vertigo. The study population included 101 patients with vertigo and spondylosis, 66 patients with spondylosis without vertigo, and 62 healthy controls. A bilateral decrease in the VA blood flow velocities were measured in patients with cervical spondylosis. A negative correlation was found between the stage of cervical degenerative changes and the flow velocities in patients with vertigo, while this relationship was not found in patients without vertigo. The CDUS evaluation of the pretransverse and transverse segments of VAs demonstrated significantly reduced flow velocities in patients with spondylosis. The degenerative changes in the cervical spine seem to be related to these velocity changes in the subgroup of patients who are also affected with vertigo. The pretransverse segment of the VA provides valuable measurements as well as transverse segment of the VA, and it can be used as an appropriate segment for CDUS examination in cervical spondylosis and associated vertigo.

Obscure gastrointestinal bleeding is an important dilemma. Brunner's gland hamartoma is an extremely rare tumor generally localized in the duodenal bulb. We present a 34-year-old woman who had suffered from several episodes of melena for the past three years. Endoscopic examinations were normal. Computed tomography showed a large target lesion over the right abdomen and an image representing intestinal malrotation, which was supported by enteroclysis. At exploratory laparotomy, ligamentum of Treitz was located in the mid-to-right side of the columna vertebralis, and the duodenal bulb was found to be invaginated into the proximal jejunum. After longitudinal duodenotomy, a pedunculated ring-shaped large polyp originating from the pyloric ring was seen and excised. Histology was consistent with Brunner's gland hamartoma. This case with obscure bleeding was original with respect to its rarity and being a huge, ring-shaped tumor with pyloric localization. Moreover, the patient had a rare clinical presentation of duodenojejunal intussusception with accompanying intestinal malrotation.

The purpose of our study was to investigate whether CT venography (CTV) performed after CT pulmonary angiography (CTPA) using 64-MDCT provides additional findings in the diagnosis of thromboembolic disease.Three hundred six consecutive patients in whom pulmonary embolism (PE) was clinically suspected were included in the study. The study group was classified according to the diagnostic quality of the CTPA examinations, the presence or absence of PE and deep venous thrombosis (DVT), and the most proximal localization that the embolus could lodge in the pulmonary artery.The diagnostic quality of CTPA was insufficient in 5.9%, acceptable in 8.2%, and excellent in 85.9% of the patients. The diagnostic quality of CTV was insufficient in 11.4%, acceptable in 47.4%, and excellent in 41.2%. The percentages of nondiagnostic examinations for CTPA and CTV were 5.2% and 10.8%, respectively. Acute PE and acute DVT were observed in 25.2% and 18.0%, respectively. The percentage of subsegmental emboli among patients with acute PE was 15.6%. The percentage of patients with thromboembolic disease was 29.1%. Of patients who were diagnosed as having thromboembolic disease, 13.5% (12 of 89 patients) had DVT only. Of all patients, 3.9% (12 of 306) had only isolated DVT. The number of patients with subsegmental PE who had DVT was two (0.7% all patients).As in MDCT scanning with a smaller number of slices, the combination of CTV with CTPA in 64-MDCT results in a small but definitive increase in the percentage of patients with a diagnosis of thromboembolic disease.

This study evaluated the changes in oxidative status in hepatosteatosis patients in terms of lipid peroxidation, nitric oxide (NO) and paraoxonase 1 (PON1) activity. A total of 49 patients with hepatosteatosis (29 males and 20 females, mean age 47.2 ± 3.6 years) and 25 healthy subjects (15 males and 10 females, mean age 46.1 ± 3.2 years) were enrolled in the study. Serum PON1 was measured spectrophotometrically, malondialdehyde (MDA), an end-product of lipid peroxidation, was determined using the thiobarbituric acid method, and NO was assessed using the Griess reaction. Lipid and other biochemical parameters were determined by routine laboratory methods. PON1 activity and NO levels were significantly decreased and MDA levels significantly increased in hepatosteatosis patients compared with healthy subjects. PON1 activity was correlated with MDA level and NO level. In conclusion, oxidative stress seems significantly to suppress PON1 synthesis in hepatosteatosis patients. In addition, oxidative stress and oxidant–antioxidant imbalance may be part of the cytotoxic mechanisms leading to liver cell injury.

We aimed to describe the clinical and multidetector computed tomography (MDCT) angiography findings of celiac, mesenteric, and renal artery entrapment by the median arcuate ligament.Patients (n = 453) who underwent MDCT abdominal aorta angiography in a period of 3 years were retrospectively reviewed for vascular compression by median arcuate ligament known as median arcuate ligament syndrome. The MDCT examinations were performed with 16-slice (n = 292) and 64-slice scanners (n = 161). The median arcuate ligament itself and adjacent vascular branches of abdominal aorta were assessed for compression by 2 different radiologists who are experienced on MDCT angiography more than 3 years. Both axial, multiplanar reformatted images and 3-dimensional angiographies were used for interpretation.Twelve patients were found to have clinically significant vessel entrapments by median arcuate ligament; 6 of them with celiac artery, 4 of them with renal artery, and 2 of them with both celiac and mesenteric artery involvement. Patients with celiac and mesenteric vessel entrapments presented with epigastric pain. All patients with renal artery entrapment had resistant hypertension. The MDCT showed the proximal narrowing caused by compression of median arcuate ligament. The proximal portions of renal arteries pulled down and in toward the aorta, with mild to moderate narrowing.The MDCT exanimation with multiplanar images and 3-dimensional angiography is a noninvasive imaging technique that can be used with high accuracy in the diagnosis of median arcuate ligament syndrome.

The aim of the study was to evaluate the incidence of pulmonary metastases detected on thoracic computed tomography in patients with rectal cancer and assess the association between the incidence of pulmonary metastases and the stage of the rectal tumor.Fifty-six consecutive patients who were diagnosed with rectal cancer over a 22-month period were included in the study. These patients had local tumor staging with a pelvic magnetic resonance imaging and staging computed tomographic scan of the chest and upper abdomen immediately after the magnetic resonance imaging. Two radiologists retrospectively reviewed all the thoracic imaging performed on these patients for the presence of metastases. The presence of a parenchymal lung nodule (greater than or equal to 1 cm if single and 0.5 cm if multiple) with a soft tissue component without calcification on lung and mediastinal window settings was considered positive for the presence of metastasis. All other patients were considered as not having any lung metastases.Of the 56 patients, 10 (17.9%) had evidence of pulmonary metastases on computed tomography. Of the 56 patients, there were 3 patients with stage T1, 24 with T2, 26 with T3, and 3 with stage T4 tumors. Of these 10 patients, 1 had a stage T2 tumor, 7 had T3, and 2 had stage T4 tumors. Statistical analysis using exact logistic regression showed the odds of getting lung metastases is an increasing function of tumor grade.There is a high incidence of lung metastases in patients with rectal cancer, and thoracic computed tomographic scanning should be performed as part of a staging protocol in all patients before any form of treatment is planned. There is a higher incidence of lung metastases with higher T stage.

OBJECTIVE. Our objective was to describe the technique and outcome of CT-guided injection of botulinum toxin into the diaphragmatic crus in a patient with hypertension caused by left diaphragmatic crus compression of the left renal artery.CONCLUSION. After the procedure, the patient's hypertension disappeared. We propose this technique, which directly targets inhibition of overactivity of the diaphragmatic crus, for treatment of hypertension caused by diaphragmatic compression of the renal artery as an alternative to surgery and renal artery stenting.

The authors investigated the relationship between the angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism and the blood flow characteristics of common carotid (CCA) and brachial arteries (BA) by color Doppler ultrasound (CDUS) in patients with acute anterior myocardial infarction (AAMI). Sixty four patients (11 women and 53 men), aged 25 to 77 years, with AAMI were studied. The ACE genotypes were established. Peak-systolic (PSV) and end-diastolic velocity (EDV) of right and left CCA, PSV of right BA, and intimal-medial thickness (IMT) of both CCAs were measured by CDUS. All results were evaluated statistically. The ACE genotypes were distributed as follows: 43.8% DD, 43.8% ID, and 12.5% II. PSVs of BA and both CCAs were lower in patients with DD and ID than with II (p0.05). IMTs of both CCAs did not differ among patients with various ACE genotypes (p>0.05). These results suggest that ACE I/D polymorphism influences Doppler blood flow parameters of both BA and CCA, but does not affect IMT of CCA.

Background: Genetic influence on Doppler blood flow parameters of carotid and brachial arteries (BA) is uncertain. We investigated the relationship between the angiotensin II type-1 receptor (AT1R) gene polymorphism and the blood flow characteristics of common carotid arteries (CCA) and BA by color Doppler ultrasound (CDUS) in patients with a first anterior acute myocardial infarction (AMI). Methods and Results: Sixty-seven patients (15 women and 52 men), aged 25–77 years, with anterior AMI were studied. The AT1R genotypes were established. Based on the polymorphism of the AT1R, they were classified into three groups: AT1R AA genotype (Group1, n = 42 patients), AT1R AC genotype (Group 2, n = 17 patients), and AT1R CC genotype (Group 3, n = 8 patients). Peak-systolic velocity (PSV) and end-diastolic velocity (EDV) of right and left CCA, PSV of right BA, and intimal-medial thickness (IMT) of both CCA were measured by CDUS. All results evaluated statistically. The AT1R genotypes were distributed as follows: 63% AA, 25% AC, and 12% CC. PSV of BA and both CCA were higher in patients with CC and AC than AA (P < 0.05). Also, IMT of both CCA were also higher in the same groups (P < 0.05). Conclusions: Our results suggest that AT1R gene polymorphism influences Doppler blood flow parameters of both BA and CCA, and IMT of CCA. Although further studies are required.

Objective: To investigate the efficacy of medical antituberculous treatment in patients with tuberculous cervical lymphadenitis (TCL).Methods: In the period 1996–2002, 73 TCL patients were reviewed and the results of clinical and laboratory testing were documented. The efficacy of a four-drug chemotherapy regimen was investigated.Results: Purified protein derivatives (PPD) skin test results were positive in 58 (79 per cent) patients. Chest X-rays revealed changes consistent with tuberculosis in nine (12.3 per cent) patients. The mean duration of medical treatment was 10.04 months. In follow-up evaluation, 14 (20 per cent) patients were considered suspicious for resistant TCL and total excision of all nodes was performed. Histopathology confirmed TB in only 10 of these cases.Conclusion: The high incidence of residual disease in our study indicates that medical treatment (at least nine months of four combined antituberculous drugs) did not seem to be effective. If lymphadenopathy persists, total surgical excision of lymph nodes should be the treatment of choice.

A 65-year-old male patient presented with right upper-quadrant abdominal pain. Ultrasonography revealed hypoechoic lesion in the perihepatic and intraparenchymal area. Computed tomography (CT) showed hypodense lesion in the same localization. A fine needle biopsy specimen of the perihepatic lesion was hemorrhagic. On abdominal CT, the liver showed enhancement, but the spleen did not enhance. The spleen could not be detected by scintigraphic imaging using Tc99m sulfur dioxide. A diagnosis of primary amyloidosis was made by renal biopsy. Melphalan 10 mg/day for 4 days/month was started. The clinical and radiological follow up demonstrated a resorption of the hematoma. The patient is still alive at the eighth month of therapy.